HomeMy WebLinkAbout022-738-22-4305-PVY-2024-003 SAWYER COUNTY ZONING&CONSERVATION ADMINISTRATION �
10610 Main Street,Suite 49 �
Hayward,Wisconsin 54843-0676
(715)634-8288 �
www.sawvcrcountveov.ore �
NON-PLUMBING SANITARY PERMIT APPLICATION �
In accordance with Chap[er DSPS 391,W is.Adm.Code and �,
Sawyer Counry Private Sewage System Ordinance �
APPLICATIONINFORMATION-TYPEORPRINT PAGE:Iaf3 V'�
Pi�vp'e�ny Owner Name y Propcny�I.cgnl Dacriplion
W�n� G\Vif� �L�Vy� GL ,j`.i: '/.�_'/., S o�,T 3�N,R�W
Propcny O�mcr's Mniling Addras I.ot Numbcr Blak Number
l �G� � d'
Ciry,Smtc 7_ip Calc Phono Numbcr Subdivuion Nemc m CSM Number
�AcL �ct t,�)► S4a�� c7is��y9�-v3c��� 3 3 #t'7 q N�
TYPE OF Bl1ILDING:(Check one) State Owned ciiy Nca�cst Rood w r„�Z�
❑Public �1 or 2 Family Dwelling-No.of bedrooms� ��'��0s`
'�Town o(RI.��5.`��/l Fim Numbcr# -�-3�(G
PUBLIC BUILDING/LAND USE:[F'xplain ihe usdpurpnsc frn this Parcel Taz Number.Q2 digit legacy number)
permit.(i.c..campsround.falivel,reawtionlenkneinment cvent eic.11 ���-� 2 �-(��'��� �
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TYPE OF PERMIT: TYPE OF NON-PLUMBING DEVICE/SYSTEM/1'OILETNNIT:
❑Privy-Pit Toilet(CSTN 1
�$;Non-Plumbing(Privy,Toilet,Restroom,Etc.) ❑Privy-Vault Toilet(200 gal. mia capacity requ'ved)
(Vault size:_�allons or cubic yards
❑Other: Vault Privy Type:❑Concrete�Steel OPolyethylene❑Other
❑Composting Toilet System ❑Incinerating Toilet Device
�porcable Restroom Unit ❑Other
RESPOIYSIBILITY STATEMENT:
l,lhe undersigned,assumc rcsponsibility(or thc installation of ihe non-plumbing sanitaty ryrcm for which this permit is iswed.1 fucther agrce�hat
any dwelling in conjunc�ion with Ihis permi��rill not be provided with indoor plumbing and/or waitt hookup. 1 will usc thc non-Qlumbing system
indicatcd as a mcans of wasic disposal,anJ 1 will carty watcr w nnd from ihe strucwre. I understand that bcfofc indoor plumbing end wnter hook ups
arc instnllcd,the proper S�ute ond County Pcrmi�c wili bc applial for. 1 funhcr understand that nny dcvintions Crom thc ebove will wnstitutc a
violntion of Suwycr Cuumy Ordinnnces ond would subject me W tbe penelties of tl�e Ordinnnas. By signing ihis applic¢tion,[nm elso granting
permission lo the zoning dcparlmem perwnnci m enter my property at any reasonnbie time(or thc purpox of inspeaion lo assure complience with
the zoning and saniwtion lews relative to thc issuance of�his permit.
�1Yfler s N0111c:,(P(Inl) OWt1cr'S Signalure: , �j
w�� P��t�;n C�z� ��,�� �. � �� - .�,�. r
OFFICE US ONLY:
❑Disepprovcd Pcrmit Fcr CST No. Da��Issu i Issuing Agcm Sign�urc
�A rov �{ ❑ONircr Givcn Initiel SI50.00 N � ^ ��; 2y 7�,��1c:�jNtic,kr."
� �o �� pdvcrsc[ktcrmination
CO MENTS:
"Expires 2 yeers(rom date of issue
'NO REFUNDS AFTER ISSUE OF PERMIT
SHORELINE PROPERTY: YES❑NO If"Yes,"Name of the body of warer: rc' ���r
CONDITIONS OF APPROVALJREASONS FOR DISAPPROVAL:
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.rLiiY u�..
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Rev.04/29/l6 w L '<
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NON-PLUMBING SANITARY PERMIT APPLICATION
PAGE:2 of 3
Privy Plot Plan
�� ��
Please include thc following information with distaaces on the above plot plan:
❑ North Arrow
❑ Neazest Road
❑ Site Address
❑ Structures
o Well
❑ Property Lines
❑ Lake, River andlor Stream
❑ Wetlands
Minimum Setback Requirements:
• ]0' from any slab construc[ed accessory building
• 25' from any habitable building
• 45' from any property line
• 50' from any watcr supply well
• 75' from the ordinary high water mark of navigable waters
• 130' from the centerline of state hibhways or 66' from right-of-way line, whichever is greater
Rcv.04/29/16
NON-PLUMBING SANITARY PERMIT APPLICATION
PAGE:� of�
General Requirements,Recommendations aud Standards:
1) The privy swcture should be insect and vermin proof.
2) All windows,ventilators and other openings should be screened with#16 mesh to prevent entrance
ofinsects.
3) The privy structure should be provided with cross ventilation of 2 square feet of screened opening
for each seat.
4) Privy doors should swing and be self-closing.
5) Privy seats should be provided with hinged covers.
6) The entire installation should be kept clean and sanitary.
7) Freshly slaked lime or other equally effective disinfectants should be used at frequent intervals for
odor control.
S) Floors, walls, seats and urinals should be scrubbed as often as possible.
9) The outer base of the privy should be banked with earth.
]0)Concrete,cement block or metal flashing should extend 6"above the ground and 12" below the
ground to prevent entrance by insects and vermin.
11)The footprint of any privy structure shall not exceed 40 squaze feet and not be used for storage.
12)Maximum height of any privy structure is limited to 10'.
13)Privies for public buildings shall comply with SPS 353.63
14)For open pit privies the bottom of the pit shall be a minimum of 36"above any restrictive factor
(ground water, saturated soils, bedrock, etc.).
15)A certified soil test is required for open pit privies and must be filed in the zoning office before
permits will be issued.
16)A certified soil test is not required for a sealed vault privy.
l7)Sealed vault privies shall have a water tight vault made of materials approved by the Department of
Safery and Professional Services(DSPS).
18)Sealcd vault privies should be ventilated with a pipe of at least 3" in diameter which terminates at
least 1' above the roof of the privy and in accordance with s. SPS 38231 (16)(a)to(�.
19)The sealed vault privy should be pumped out when nearly full by a licensed septic hauler/pumper in
accordance with ch. NR 113.
20)According to DSPS 391.12, the storage chamber of a sealed vault privy shall have a minimum
storage capacity of 200 gallons or one cubic yazd.
21)The storage chamber of a sealed vault privy shall conform with the requirements of DSPS 384.25
relating to holding tanks.
Rev.04/29/16
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SITE PLAN
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Wisconsin Administrative Code prohibits roof drains & sump pumps to be hooked to sanitar
**I certify that the requirements of Wisconsin Administrative Code Ghapter NR447, including a thoro�
and, if required, a notification or intent to dema►lish and/or renovate, have been met.**
�
I understand that all land use permit fees are non-refund'abl�
Signature of Owner or Authorized Agent with Power of Attorney
Print Name
The above certifies that the listed information and intentions are true and conect, that all work shall be perfor
the requirements of Ordinance No. 148 and its amendments of the City of Hayward and the laws and regulatio
Wisconsin, and if acting as owner(s} agent, has the permission of the owner(s) to perForm the work requested
above person(s� hereby give permission for access to the property for onsite inspection.
Issue date Expiration
For Office Use Onlv
Total Fee Required: $
UDC Permit Required? Y N
Fees Paid:
State Approval Required? Y N Land Use: �
Electrieal: $
Planning Commission? Y N Plumbi�g: $
1/10l24,131 PM Real Property�is�ing Page
R2dl EStdte Sawyer County Property Listing Property5tatus: Current
Today's Date:1/10/2024 Created On:1/3/2019 335:18 PM
�Description Updated:5/6/2020 `i'�Ownership Updated:6/18/2018
Tax ID: 41678 WENDY LEW CLAYTON WI
PIN: 57-022-2-38-07-22-4 03-000-000050
Legacy PIN: 022738224305 Billing Address: Mailing Address:
Map ID: WENDY LEW WENDY LEW
Munitipality: (022)TOWN OF RADISSON 81 90TH AVE 81 90TH AVE
STR: 522 T38N R07W CLAYTON WI54009 CLAYTON WI54004
Description: PRT SWSE LOT 2 CSM 33/32#7949
Recorded Acres: 8.080 w Site Address *indicates Private Road
Cakulated Acres: 8.146 3386N STATE HWY 40 EXEI.AND 54835
Lottery Claims: 0
First Dollar: No iJ property Assessment Updated:4/11/2014
Waterbody: Couderay River 2023 Assessment Detail
Zoning: (A-1)Agricultural One
ESN: Code Acres Land Imp.
G6-PRODUCTIVE FOREST 8.080 13,000 0
��Tax Districts Updated:1/3/2014 Z-year Comparison 2022 2023 Change
1 State of Wisconsin Land: 13,000 13,000 0.0%
57 Sawyer County Improved: 0 0 0.0%
022 Town of Radisson 7otal: 13,000 13,000 0.0%
576615 Winter School District
O01100 Technical College (�
��L"R Property History
. Recorded Documentr Updated:6/18/2018 parent Properties Tax ID
QUIT CLAIM DEED 57-022-2-38-07-22-4 03-000-000010 22696
Date Remrded:6/15/2018 412824
CERTIFIED SURVEY MAP
Date Recorded:11/19/2013 388342
MAP OF SURVEY
Date Recorded:4/24/2009 22387-21
MAP OF SURVEY
Date Recorded:9/25/2008 22387-18
QUIT CLAIM DEED
Date Recorded:12/2/2004 327039
COVENANTS
Date Recorded:5/23/2003 311455 852/661
Child HistoiyBecor�Colint 1-__— ___ —— _
- _— ---- - —_
HISTORY 0 Expand All History White=Current Parcels Pink=Retired Parcels
O Tax ID:22696 Pin:57-022-2-38-07-22-4 03-000-000010 Leg.Pin:022738224301 Map ID:.I5.1
41678 This Parcel Parents Children
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C,:=_reatcd: 1'10:2024
Last Oata Uplcaded: 1.'l0i 2024 5:55:38 A'�1
Deve6�ped by
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